Individual provider Active NPI

Amanda Rose Watroba, PT

  • Physical Therapist
  • Elizabeth City, NC
National Provider Identifier
1417402934
Registry record updated Jun 10, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
MP13 Issued in NC
Practice address
1401 London St
Elizabeth City, NC 27909-5614
Phone
(252) 261-1556
NPI assigned
Aug 25, 2016
Last updated
Jun 10, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 10, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PTL21959 MA
Physical Therapist 225100000X 303317 CA
Physical Therapist 225100000X MP13 NC Primary

Addresses

Primary practice location

1401 London St
Elizabeth City, NC 27909-5614

Mailing address

2645 N 17TH St
Coos Bay, OR 97420-2134
Phone (541) 266-3658

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, NC2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20230111000704 CA Practitioner - Physical Therapist in Private Practice 5991092652 Reassigns benefits to 2 organizations
I20251029001135 NC Practitioner - Physical Therapist in Private Practice 5991092652 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Coastal Rehabilitation IncGroup PAC ID 9537071535, 17 clinicians
Sand Coast Rehab Physical Therapy IncGroup PAC ID 7315352911, 131 clinicians

Practice addresses (Care Compare)

101 Medical Dr
Elizabeth City, NC 27909-3361
Phone (252) 338-2114

3921 Cochran St
Simi Valley, CA 93063-2364
Phone (714) 915-2604

503 Cypress LN
Suite a
Manteo, NC 27954-8016
Phone (252) 473-9633

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PTL21959MAMDPhysical Therapist
MP13NCMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Coastal Rehabilitation Inc Physical Therapist CurrentSince Sep 1, 2025 Accepting new patients
Sand Coast Rehab Physical Therapy Inc Physical Therapist CurrentSince Dec 1, 2022 Accepting new patients
Camarillo Physical Therapy, Inc Physical Therapist CurrentSince Jun 1, 2024 Accepting new patients
Coastal Rehabilitation Inc Physical Therapist Past Accepting new patients
Camarillo Physical Therapy Physical Therapist PastSince Jun 1, 2024 Accepting new patients

Locations

4000 Calle Tecate
Ste 117
Camarillo, CA 93012
Phone (805) 383-0470

3558 Round Barn Blvd
Ste 600
Santa Rosa, CA 95403

1200 Cypress Point Ln
Ventura, CA 93003
Phone (805) 650-8000

850 Hampshire Rd
Ste Ab
Westlake Village, CA 91361
Phone (805) 383-0470

101 Medical Dr
Elizabeth Cty, NC 27909
Phone (252) 338-2114

503 Cypress Ln
#A
Manteo, NC 27954
Phone (252) 338-2114

400 Route 70
Lakewood, NJ 08701
Phone (440) 263-9228

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1472083200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1781049600000",
    "number": "1417402934",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2645 N 17TH ST",
            "city": "COOS BAY",
            "state": "OR",
            "postal_code": "974202134",
            "telephone_number": "541-266-3658"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1401 LONDON ST",
            "city": "ELIZABETH CITY",
            "state": "NC",
            "postal_code": "279095614",
            "telephone_number": "252-261-1556"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WATROBA",
        "first_name": "AMANDA",
        "middle_name": "ROSE",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-08-25",
        "last_updated": "2026-06-10",
        "certification_date": "2026-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MA",
            "license": "PTL21959",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "303317",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NC",
            "license": "MP13",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elizabeth City, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.